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British Journal of Anaesthesia, 1993, Vol. 70, No. 3 280-285
© 1993 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

IMPROVEMENT IN I.V. REGIONAL ANAESTHESIA BY RE-EXSANGUINATION BEFORE SURGERY{dagger}

N. RAWAL, M.D., PH.D, J. HALLEN, M.D, A. AMILON, M.D and P. HELLSTRAND, M.D

Department of Anaesthesia Örebro Medical Center Hospital S-701 85 Örebro Sweden
Department of Hand Surgery Örebro Medical Center Hospital S-701 85 Örebro Sweden

A modification of an i.v. regional anaesthesia (IVRA) technique is described in which the arm is re-exsanguinated before surgery (re-IVRA). IVRA and re-IVRA were compared for quality of operative field, sensory and motor block, quality of analgesia and blood concentrations of prilocaine, lignocaine and mepivacaine in a double-blind study in 120 patients undergoing hand surgery. Re-IVRA provided a significantly better surgical field without affecting sensory or motor block. Re-exsanguination improved tolerance of the tourniquet. Plasma concentrations in the re-IVRA group showed some increases, but these were not in the toxic range. (Br. J. Anaesth. 1993; 70: 280–285)

{dagger}Presented in part at the American Society of Regional Anesthesia (ASRA) meeting, Cincinnati, April 1991 and at the Scandinavian Society of Anaesthesiologists meeting, Trondheim, Norway, June 1991.


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